Healthcare Provider Details

I. General information

NPI: 1093664716
Provider Name (Legal Business Name): JAYCOB I SNEED
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 02/23/2026
Certification Date: 01/26/2026
Deactivation Date: 02/01/2026
Reactivation Date: 02/23/2026

III. Provider practice location address

24355 LYONS AVE STE 225
SANTA CLARITA CA
91321-2336
US

IV. Provider business mailing address

15041 WESTCLIFF DR
SYLMAR CA
91342-5475
US

V. Phone/Fax

Practice location:
  • Phone: 661-254-7086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: